Laparoscopic nephrectomy for Wilms' tumor: Can we expand on the current SIOP criteria?
| Autor: | Martin Campbell, Aurore Bouty, Annie Roberts, Michael Nightingale, Yves Heloury, Katherine Burnand |
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| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty Adolescent Urology medicine.medical_treatment 030232 urology & nephrology Renal hilum Medical Oncology Nephrectomy Wilms Tumor 03 medical and health sciences 0302 clinical medicine Surgical oncology Positive Margins Medicine Humans Laparoscopy Surgical treatment Child Societies Medical Retrospective Studies medicine.diagnostic_test business.industry Laparoscopic nephrectomy Infant Wilms' tumor medicine.disease Kidney Neoplasms Surgery medicine.anatomical_structure Treatment Outcome 030220 oncology & carcinogenesis Child Preschool Pediatrics Perinatology and Child Health Female Guideline Adherence Neoplasm Recurrence Local business Tomography X-Ray Computed Follow-Up Studies |
| Zdroj: | Journal of pediatric urology. 14(3) |
| ISSN: | 1873-4898 |
| Popis: | Summary Introduction Wilms' tumor now has a good overall prognosis with open radical nephrectomy having been the mainstay of surgical treatment. Recently laparoscopic nephrectomy (LN) has been growing in popularity. The aim of our study was to review our indications and outcomes for laparoscopic resections for Wilms' tumor and compare indications with International Society of Paediatric Oncology (SIOP) criteria for LN. Material and methods Patient demographics, preoperative management, surgical data, respect of SIOP criteria, complications, disease outcome, and follow-up were recorded on consecutive children who underwent nephrectomy for Wilms' tumor. Results and discussion Fifty-four consecutive children with Wilms' tumor underwent a nephrectomy; 20 had a LN (Table). Nine of 20 (45%) patients who had LN did not meet SIOP criteria for LN. No patients had an intraoperative tumor rupture and one patient had positive margins because of preoperative rupture. There were two conversions: one caused by difficulty accessing the renal hilum and the other caused by difficulty maintaining oxygen saturations. There was one local recurrence. Conclusion SIOP criteria are conservative and safe. Indications can be extended for teams experienced in surgical oncology and laparoscopy after agreement at a multidisciplinary meeting (MDM). Table . Comparison table of open versus laparoscopic nephrectomy. Open nephrectomy Laparoscopic nephrectomy Total 34 20 SIOP criteria for laparoscopic nephrectomy met 0 11 Margins involved 5 1 Lymph nodes harvested (mean) 4.6 4.8 Recurrences 5 1 |
| Databáze: | OpenAIRE |
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